摘要:

Fifty-eight patients were systematically interviewed at the time of their entry into a home hemodialysis training program. The social, demographic, medical, and psychological characteristics of the sample are described. On interview, 13 (22 per cent) of the 58 patients were found to be experiencing rigorously defined depressive disorder. The importance of further study regarding the incidence of depressive illness in similar groups of patients and the need for further research in defining adequate therapy for these patients are emphasized.

ISSN:0022-3018    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Narcotic addicts from Laos were treated under governmental auspices in two settings: a Buddhist monastery in Thailand, and a medical facility in Laos. Treatment at the monastery included “eold turkey” withdrawal, a herbal emetic, prayer and religious exortation. Treatment at the medical program consisted of methadone detoxification, care of associated medical conditions, counseling, education regarding addiction, and group discussions. Addicts voluntarily selected one of the alternative modalities. Cost per individual treated was $150 at the medical facility, and about one third that amount at the monastery.Those choosing the more traditional monastery program had an older mean age and included a greater proportion of females and ethnic Lao people. Expatriate Asians (an educated, urban group) and tribal addicts (predominantly non-Buddhist) were more numerous at the medical facility. Small differences were noted in addiction history between the two groups; these were probably due to the demographic differences between the groups.Follow-up evaluation on representative samples was conducted 6 to 18 months postdischarge using abstinence as a criterion. Correction was made for regional differences in opium availability and cost. No difference was found in abstinence rates between the monastery and medical programs.Mortality among addicts over age 60 years was considerably higher at the monastery than at the medical facility. Subjective evaluation of the treatment experience at the temple was positive among Lao addicts (a group ethnically similar to the Thai), but negative among tribal addicts. Over time fewer addicts chose the monastery program, while the medical program became increasingly popular as a treatment resource.

ISSN:0022-3018    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Twenty chronic alcoholics and a group of matched control subjects were tested on verbal and visuospatial memory tasks in order to test directly the hypothesis that alcoholism disturbs cognitive functions subserved by the right hemisphere more than those subserved by the left hemisphere. The results provide some support for the hypothesis and indicate that information may be lost by pooling together test results from alcoholics which come from a mixture of verbal and nonverbal tasks.

ISSN:0022-3018    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Anecdotal reports from psychotherapists frequently suggest that theoretical guidelines are not readily adhered to in actual practice. Previous studies have found marked differences in viewpoint on many aspects of technique and practice among even relatively homogeneous groups of psychotherapists. In order to explore further the discrepancies between specific theoretical issues in psychotherapy and their practical clinical applications, the authors surveyed a large group of experienced, practicing psychodynamic psychotherapists. A comprehensive questionnaire addressing theoretical issues such as transference, countertransference, and goals of therapy was constructed. In all there were 70 items and respondents were requested to rate each item in terms of psychotherapy “as you practice it.” Numerous discrepancies between theoretical belief and clinical practice were found. Almost all of the 81 respondents agreed that the therapist should not impose his value system on the patient, yet half of the group viewed the therapist's encouragement of the enrichment of the patient's social life and encouragement of educational and vocational pursuits as an important aspect of the therapy. A significant number agreed that giving suggestions and advice to the patient may be harmful, but an equal number felt that the therapist should encourage more adaptive modes of behavior including sexual intimacy in the patient's outside life. Marked disagreements were found over issues of dependency, controlling the patient's outside behavior, and the development of countertransference feelings. Analysis of the data by age revealed that older therapists allowed themselves to be more liberal in their attitudes to such issues as the development of dependency by the patient, the promotion of the enrichment of the patient's social life and the development of countertransference than younger therapists. This study confirmed the presence of striking discrepancies between theoretical belief and clinical practice in dynamic psychotherapy. In particular, the incongruities in the data indicate that therapists may prefer a value-free therapy as an ideal, but invariably bring their personal values into the treatment situation.

ISSN:0022-3018    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Hypochondriasis and paranoia are common psychopathologies of aging. The former may be secondary to depression or organic brain syndrome, whereas the latter may be secondary to sensory impairment or organic brain syndrome. Paranoid schizophrenia, with delusions of grandeur, is rare in later life. The authors classified 273 institutionalized geriatric patients by means of staff ratings into categories such as lucid and alert, confused, hypochondriacal, paranoid, etc. Among confused patients there was a correlation of .45 (p< .001) between hypochondriasis and paranoia. Even among nonconfused patients, there was a slight positive correlation. The authors concluded that geriatric paranoia and hypochondriasis have similar structure (delusion) and functions (safeguarding self-esteem and manipulating others). An interpersonal perspective can also provide guidelines for when to treat these conditions.

ISSN:0022-3018    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

This study suggests that patients receiving daily doses of 40 mg of prednisone or its equivalent, are at greater risk for developing steroid psychosis. Psychotic reactions were twice as likely to occur during the first 5 days of treatment as subsequently. Premorbid personality, history of previous psychiatric disorder, and a history of previous steroid psychosis did not clearly increase the patient's risk of developing psychotic reaction during any given course of therapy.Steroid psychoses present as spectrum psychoses with symptoms ranging from affective through schizophreniform to those of an organic brain syndrome. No characteristic stable presentation was observed in these 14 cases reported here. The most prominent symptom constellation to appear some time during the course of the illness consisted of emotional lability, anxiety, distractibility, pressured speech, sensory flooding, insomnia, depression, perplexity, agitation, auditory and visual hallucinations, intermittent memory impairment, mutism, disturbances of body image, delusions, apathy, and hypomania.Phenothiazines administered in average daily doses of 212 mg produced excellent response in all patients studied. Of particular note was the fact that tricyclic antidepressants produced an exacerbation or worsening of the clinical state in all patients to whom they were administered.

ISSN:0022-3018    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Four hundred sixty-nine female and 311 male college students were administered a depression scale, an analogies test, and questions related to expectations and evaluations of performance. As predicted, significant negative correlations were found between subclinical depression and expectations and evaluations of performance. A significant negative correlation between depression and actual performance was apparent for females only. However, this correlation was much weaker than similar correlations previously reported for college student populations. It was concluded that low performance expectations constitute one dimension of subclinical depression. This suggests that Beck's theory of clinical depression, which holds that negative self-perceptions and other cognitions are importantly involved in depression, may be useful in understanding normal mood variation. The findings also suggest that some similarities exist between clinically and subclinically depressed groups in that both groups are reported to hold low performance expectations, but display minimal performance deficits.

ISSN:0022-3018    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

The frequency with which conversion reaction diagnoses are inappropriately applied to persons with physical diseases was estimated in a sample of medical hospital patients diagnosed hysteric. This was accomplished by ratings based on file information available at the time of diagnosis and at a 10-year follow-up, and a count of patients whose “conversion” symptoms were later diagnosed as physical illnesses. The estimated false positive rate was 25 per cent. The symptoms most characteristic of the false positives were degenerative diseases and structural failures affecting the spinal cord, peripheral nerves, bones, muscles, and connective tissues. An effort to identify psychological parameters capable of separating true conversion reactions from false positives with a variety of behavioral symptoms and Minnesota Multiphasic Personality Inventory scores was not productive.

ISSN:0022-3018    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Eight depressed patients received 150 mg of clomipramine for 4 weeks. They completed the Profile of Mood States five to seven times the first week of treatment and five to seven times at the end of treatment. Moods showing significant decrease from the beginning to the end of the first week were: tension-anxiety, depression, anger-hostility, and confusion. The only changes from the beginning to the end of the 4-week period were an increase in vigor and a decrease in fatigue. The occurrence of rapid and slow mood changes with antidepressants suggested that the former were due to sedative effects and the latter occurred at the rate of the improvement in the disease depression.

ISSN:0022-3018    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

This paper uses a case from the Micronesian Island of Yap to illustrate that indicators of improvement from an episode of schizophrenic psychosis can vary tremendously from culture to culture. At times, the clinician must search diligently for such indicators since the patient will not verbalize any perception of improvement.A 39-year-old Yapese woman was evaluated by a psychiatrist and was found to have been psychotic for several years, suffering from gross delusions, auditory hallucinations, flattened affect, and social isolation. In addition, she had discontinued chewing betel nut that was used daily by virtually all of her fellow islanders on Yap.Two months after beginning treatment with twice monthly injectable antipsychotic medication she was still delusional, with flat affect, and heard the same voices. She was slightly less socially withdrawn and she had interestingly resumed chewing betel nut. It seemed that she had given up betel nut chewing during the socially withdrawn phase of her illness and had resumed it as she improved and became less autistically preoccupied. In her culture, betel chewing was a main avenue of social intercourse and an intrinsic part of almost all social activities. In her particular case, the resumption of betel chewing was a primary indicator of her improvement from psychosis and reintegration into her social group.

ISSN:0022-3018    

出版商:OVID    

年代:1979

数据来源: OVID